Correct Answer: C

Rationale: Calf pain and swelling are concerning findings that may indicate deep vein thrombosis (DVT), a known risk of tamoxifen due to its estrogen-like effects on clotting factors, requiring immediate reporting to the provider for evaluation, such as an ultrasound.
Choice A is wrong because hot flashes are a common side effect of tamoxifen due to its anti-estrogenic effects and do not typically require reporting unless severe.
Choice B is wrong because vaginal dryness is an expected side effect of tamoxifen and can be managed with non-hormonal lubricants, not requiring immediate reporting.
Choice D is wrong because a weight gain of 2 kg in 1 month is not significant and may be related to other factors; it should be monitored but does not require immediate reporting.

Correct Answer: D

Rationale: Monitoring for suicidal thoughts is critical with paroxetine, an SSRI, as it carries a black box warning for increased suicide risk, especially in the early weeks of treatment for PTSD.
Choice A is incorrect because paroxetine is typically taken at bedtime, as it can cause sedation, not in the morning.
Choice B is incorrect because paroxetine takes 4-6 weeks to reduce PTSD symptoms like flashbacks, not immediate relief.
Choice C is incorrect because paroxetine should not be discontinued abruptly, even if symptoms improve, to avoid withdrawal or relapse; it requires provider guidance.

Correct Answer: C

Rationale: Monitoring for signs of infection is critical, as prednisone, a corticosteroid, suppresses the immune system, increasing infection risk in clients with adrenal insufficiency.
Choice A is incorrect because prednisone should be taken with food to reduce gastrointestinal irritation, not on an empty stomach.
Choice B is incorrect because prednisone for adrenal insufficiency is typically a lifelong therapy, not limited to a few weeks.
Choice D is incorrect because reducing the dose without medical guidance can precipitate an adrenal crisis; dose adjustments must be supervised by the provider.

Correct Answer: B

Rationale: Avoiding alcohol is critical while taking zolpidem, a non-benzodiazepine hypnotic, as it enhances CNS depression, increasing the risk of respiratory depression or falls.
Choice A is incorrect because zolpidem is typically taken immediately before bedtime due to its rapid onset, not 30 minutes prior.
Choice C is incorrect because vivid dreams are not a common side effect; amnesia or sleepwalking may occur but are less frequent.
Choice D is incorrect because zolpidem can be taken with or without food; a snack is not necessary for absorption.

Correct Answer: A

Rationale: Folic acid is essential for DNA synthesis and cell division, and adequate intake (400-800 mcg daily) before and during early pregnancy helps prevent neural tube defects, such as spina bifida and anencephaly, in the fetus.
Choice B is wrong because folic acid does not directly increase red blood cell production; it supports hematopoiesis indirectly by aiding DNA synthesis, but this is not its primary role in pregnancy.
Choice C is wrong because folic acid does not specifically promote uterine growth; uterine growth is driven by hormonal changes and fetal development.
Choice D is wrong because there is no direct evidence that folic acid reduces the risk of preterm labor.